Physical Medicine

Hydrotherapy
Swimming
Hot and Cold therapy

Hydrotherapy
Therapeutic use of water in any of its three forms to
restore and maintain good health in animals

hydrotherapy
uses

immersion full
body or partial
exercises(swimmi
ng,water walking)

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local appilcation
cool or warm
water wraps or
packs

ingestion/inhalati
on (steam)

Water properties
Density/Specific gravity
Buoyancy
Viscosity and Surface Tension
Hydrostatic pressure

Archimedes Principle

Buoyancy
upward thrust force
exerted to a body partly
or totally submerged in
water which results in
an
effect
of
decreased weight.

Buoyancy reduce the

weight being supported
by the patients limbs

When a body is entirely or

oartially immersed in fluid at rest..
It experiences an upward thrust equal to
the weight of water displaced.

Buoyancy

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Levine et al.,2004

Specific Density of an Object- ratio of the

weight of the object to the weight of an equal
volume of water

Specific gravity
of pure water : 1
lean animalshave tendency
to sink
obese
animals- float
more easily

Viscosity and Surface tension

-Water is more dense and viscous than air which
increases resistance to movement
-viscosity also supports the patient
easy to maintain balance than in land
Eg. For dogs, a five minute swim is often quoted
as being the equivalent of a five mile run.

 Hydrostatic Pressure
Pascal's Law
Fluid exert pressure
on all surfaces of an
immersed body at any
given depth
Lower limb immersed in
water- pressure causes
a
massaging
effect
upwards
which
aids
venous return and reduce
oedema formation

Swimming
A non- weight bearing exercise in which the limbs
work against the resistance of water in a symmetrical
pattern (Bromiley, 1991)

A common form of hydrotherapy or aquatherapy used in

rehabilitation of animals (dogs and horses)

Swimming

Underwater
treadmills

Hydrotherapy pool

Bath tub

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Mechanism of Action
Increases muscle strength and mass
- viscosity ,surface tension
decrease pain and Increase range of motion
- buoyancy and viscosity
Increase cardiovascular fitness
- buoyancy and resistance
enhance venous return and reduces edema
- hydrostatic pressure

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 Indications/applications in animals

Orthopedic disorders
Neurologic disorders
Muscle atrophy
Decreased joint function and range of motion
Limb edema

13

 Specific disorders where hydrotherapy is indicated as part

of rehabilitation include:
Dogs:

Fractures
CCL rupture
Total hip osteotomy
Arthritis
Intervertebral disk disease
joint effusions

14

Effects of postoperative rehabilitation on limb function after

cranial cruciate
ligament repair in dogs
Marsolais
Controlled
study et al., 2002
home exercise dogs vs. dogs hospitalised for intensive
rehabilitation on three alternate weeks during their early recovery
period.
Method: Hospitalized : dogs swam twice daily for between 10 and
20 minutes, five days a week on these three weeks.
Result :Using force plate analysis, six months following surgery, the
swimmers were less lame on their operated limb than restricted
exercised dogs and in swimming dogs, there was no difference
in limb function between their operated and their normal limbs.
In the exercise restricted dogs, six months following surgery, limb
function was still signifi cantly less in the surgical limbs
compared to their normal limbs
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Limitations/Contraindications
1.
2.
3.
4.
5.
6.

Open, infected draining wounds

Unhealed surgical incisions
Active gastrointestinal disease
Elevated body temperature
Respiratory compromise or distress
Systemic compromise- severe cardiac, liver, kidney
problem, hypotension,hypertension
7. Uncontrolled epilepsy
8. Advanced debility

16

Recommendation
Hip dysplasia
- Definition: abnormal development of the coxofemoral joint
characterized by subluxation, or complete luxation, of the femoral
head in younger patients and mild to severe DJD in older patients.
- Painful condition, usually dog reluctant to move ,especially large
breed commonly affected, load on joint causes contact of
acetabulum and head
- Non use of limb usually result to muscle atrophy
- Conventional treatment:
NSAIDS- Carprofen (rimadyl)
VIT E
Glucosamine chondroitin
Complementary Physical therapy:
Swimming- encourages use of limb with less load on hip
(buoyancy) - decreasing pain, improve muscle mass (stabilizing
the joint)

Heat and Cold Therapy

Cold therapy (Cryotherapy)

the application of a cold agent to an affected area of the

body to provide therapeutic effects by reducing tissue
temperature.

19

Mechanism of Action
Cold

Local
vasoconstriction

Reduces
inflammation
(reduce
edema
formation)
And
hemorrhages

Reduced tissue
Decrease
Reduce
metabolism
conduction velocity muscle
of sensory and
spasm
motor nerves
Decrease
analgesia
need for
oxygen and
nutrients
Reduced
metabolites
and heat

Techniques of cold application for horses and dogs

1. Crushed iced
2. Cold packs-3 parts water + 1 part rubbing alcohol (freezed)
3. Running stream
4. Whirlpool tubs
5. Wellie boots
6. Hosing
7. Cold bandaging
8. Frozen gamgee or cotton wool pads
Treatment: 15-25 minutes at a time ( monitor response of
tissue after first 5-10mins) 3-6 times for first 72 hours for
acute injury and post surgery.
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22

Cold Therapy
Indications:
1. Musculoskeletal trauma (acute injury)
2. Post surgical swelling
3. Local edema
4. Haematoma formation
5. Pain relief

Specific surgical procedures where cryotherapy is indicated

postoperatively for pain and swelling include:
Femoral head and neck ostectomy
Tibial plateau leveling osteotomy
Tibial tuberosity advancement

24

Effect of cold compression therapy on post operative pain,

swelling, range of motion and lameness after tibial plateau
leveling in dogs
Drygas et al., 2011
ObjectiveTo evaluate the effect of cold compression therapy (CCT)
on postoperative pain, lameness, range of motion of the stifle joint,
and swelling following tibial plateau leveling osteotomy (TPLO) in
dogs.
Animals34 client-owned dogs with unilateral deficiency of a cranial
cruciate ligament undergoing TPLO.
ProceduresDogs were assigned to 2 groups. Group 1 (n = 17 dogs)
received CCT in the 24-hour period following TPLO. Group 2 (n = 17
dogs) received no CCT. Degree of lameness, range of motion, and
circumference of the stifle joint were measured before surgery and
1,14, and 28 days after surgery. A modified composite Glasgow pain
scale, visual analogue scale, and pain threshold score were used to
evaluate signs of pain before surgery and 1,14, and 28 days after
surgery.
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 ResultsNo complications were observed, and all dogs

tolerated CCT. Use of CCT resulted in lower values for
the visual analogue scale and Glasgow pain scale
and lower pain threshold scores; lower lameness
scores; less swelling; and an increased range of
motion 24 hours after surgery. At 14 days after surgery,
there were no significant differences between groups.
At 28 days after surgery, too few data sets were
available for comparison.
Conclusions and Clinical RelevanceCCT decreased
signs of pain, swelling, and lameness and increased stifle
joint range of motion in dogs during the first 24 hours
after TPLO.
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Limitation/Contraindications:
1. Open wounds
2. Fractures
3. Areas around superficial nerves
4. Very young or old dogs

Heat therapy (Thermotherapy)

the application of a heat agent to an affected area of the
body to provide therapeutic effects by increasing tissue
temperature via conduction, convection and radiation.

Mechanism of Action
Heat therapy

29

A. Artificial sources for delivery of heat to tissues

1. Hot packs
2. Hot towels/ Hot packing
3. Hot water bottle
4. Heated pads
5. Infrared lamps- luminous/ non luminous
6. Sunlight artificial sources:
Full spectrum lights
Cradle solarium
Heat therapy applied - 72 hours post injury,15-30 mins (3-4x a day)

Cradle solarium

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Indications:
1. General malaise
2. Post trauma
3. Post surgery
4. Chronic inflammation
5. Sprains and muscle stiffness

Specific procedures or disorders that benefit from heat

therapy include:
Cranial cruciate ligament (CCL) rupture
Fracture repair
Tendon and ligament injury management
Neurologic disorders, such as intervertebral disk disease
Osteoarthritis

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1.
2.
3.
4.
5.
6.

Limitations/Contraindications:
Acute inflammation
cutaneous hemorrhage
Thrombophlebitis
Edema
Open wounds
Patients with poor thermoregulatory capacity

Contrast Bathing
Use of alternate cold and hot therapy
Cold vasoconstriction
Increased circulatory
Hot- vasodilation
flow

Technique: alternate cold and hot towel compress

every 3 minutes for 20-30 minutes

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Indications :
1. Soft tissue damage
2. Haematoma
3. Filled joints
4. Filled legs

Contraindications:
1. Open wounds
2. infections

Recommendations for Hot and Cold

Therapy
Complementary to Conventional therapies
1.Post -operative swelling: enucleation
Conventional
Complementary
- NSAIDs
cold compress-first 24 hrs
-antibiotics
warm compress after
inflammation
subsides
2. Rectal prolapse
Conventional
Complementary
-NSAIDs/Corticosteroids
Cold sugar
solution
3. Sprain
rest
cold compress- first 24 hrs

References:
1.

Bromiley,MW. 1991. Physiotherapy in Veterinary. London:

Blackwell
Scientific Publications.
2. Burnett, J. and Wardlow, J. 2012. Physical Rehabilitation
for
Veterinary
Practice. Todays Veterinary Practice. 18-20.
3. Mcgowan, C.M.,Goff, L. and Stubbs N. (ed).2007.Animal
Physiotherapy: Assessment, Treatment and
Rehabilitation
of Animals.Ames Iowa. Blackwell
Publishing. Pp 187197.
4. Drygas,KA,McLure SR, Goring,RL,Pozzi,A,Robertson,S,and Wang
C.2011.Effect of Cold Compression on
postoperative swelling
and Range of motion and lameness after tibial plateau Leveling
Osteotomy in Dogs.Journal of
American Veterinary Medical
Association.238(10)12841291.

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4. Marsolais, GS,Dvorak,G and Conzemius, MG. 2002.

Effects
of
Postoperative
Rehabilitation on limb
function after
Cranial Cruciate Ligament Repair. Journal
of American
Veterinary
Medical
Association.
220(9):1325-1330.
5.
Millis, D. Levine D. and Taylor R. 2004.Canine
Rehabilitation
and Physical
Therapy.USA.
Elsevier.pp 264-288.
6. Owen, MR . 2006. Rehabilitation Therapies for
Musculoskeletal
Disease in Small Animal
Practice. European Journal
of
Companion
Animal
Practice.16: 137-145.
7. Prankel, S. 2008. Hydrotherapy in Practice. In Practice.
30:
272- 277.
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